Diarrhoea is a condition, which results from the failure of one or more functions of alimentary canal. The alimentary canal receives mixes, digests and absorbs a wide variety and unpredictable amount of food with remarkable efficiency. What is left of the mixture of the food at the end of the alimentary canal is finally excreted as a small and convenient volume of the solid waste. Failure of the one or more of the aforementioned processes results in the passage of inconveniently bulky and liquid stools at increased frequency and is termed “Diarrhoea”. Diarrhoea is also defined as the passage of loose, liquids or watery stools. Diarrhoea is caused due to any of the following causes: abnormal motility, disturbances in intestinal permeability, or the presence of osmotically active, nonabsorbable substances in the human gut. Broadly classified as acute and chronic diarrhoea. The acute diarrhoea (gastroenteritis) is mainly infectious; the pathological mechanism may be toxin production (preformed toxin, enterotoxin and cytotoxin), enteroadherence, mucosal-invasion (minimal, variable and severe) and systemic infection (viral hepatitis). The various other infectious agents may be classified as nonopportunistic pathogens (Shigella, Salmonella, E. histolytica, Giardia lamblia etc.), opportunistic infections (protozoa and viruses), human immunodeficiency virus (bacteria). Chronic diarrhoea may again be classified as inflammatory, osmotic, secretary, altered intestinal motility and factitious.
Despite tremendous development and achievements in science and medical science, several diseases are still challenging to human beings and efforts are on to conquer them. Even as we step into the new century with exciting prospect of gene therapy, herbal medicine remains one of the common forms of therapy available to world population. With the modern antidiarrhoeal agents not giving complete cure to the disease, there is a constant lookout for agents from the traditional system, which can provide complete cure to the disease, rather than treating the symptoms of the disease.
CISSAMPELOS PAREIRA (Linn.) Hirsuta
    Family: Menispermaceae    Part used: Roots    Botanical description: Cissampelos pareira (Linn.) Hirsuta is a variable, lofty, slender, dioecious, perennial, sub erect or climbing herbs and shrubs, distributed in the tropical and subtropical world, ascending up to an altitude of 2,000 mtrs. Rootstock woody, perennial; leaves usually peltate or orbicular-reniform, ovate-sub-reniform, with a truncate-cordate base, glabrous or hairy above, 3–12 cm across; flowers greenish yellow, male in axillary, fascicled, pilose cymes or panicles, female in 6–15 cm long, pendulous racemes; drupes small, ovoid-sub-globose or obovoid, compressed, scarlet red, hirsute; seeds horse-shoe shaped. All parts of the plant are used as medicine. The dried roots form the drug, commonly known as FALSE PAREIRA BRAVA, and sometimes confused with the TRUE PAREIRA BRAVA, derived either from Chondrodendron tomentosum Ruiz and Pav., a native of Peru and Brazil, or C. platyphyllum Miers (Chopra et at, 1958). The drug consists of long, cylindrical, oval, or compressed pieces of the root, entire or longitudinally split, 0.1–1.20 cm×1.2–10.0 cm; bark grayish brown, longitudinally wrinkled, transversely crossed by annular elevations, interior wood yellowish gray, porous with concentric rings and medullary rays; aromatic and sweetish at first, turning intensely bitter later. Approximately 1.7 tones of root are cultivated every year in India (wealth of India, Vol. 3 (Revised), 1992, 591–593).    Medicinal use: Plant juice with jaggery and eggs is given internally for minor injuries. The poultice of leaves is applied to abscesses, sores, scabies, itches, pimples, boils and burns. The decoction, mixed with lemon and garlic juice and salt is given as stomachic. Being wound healer, antidote and kushthaghna, paste of leaves and root is used in fistula, purities, skin disorders and snake poison externally. Internally it is useful in anorexia, indigestion, abdominal pain, diarrhoea and dysentery. It is blood purifier and has anti-inflammatory property. It is also used in cough and dyspnoea and as it purifies breast milk it is used in various disorders of breast milk secretion. It is a potent diuretic.    Phytochemistry: The root and leaves contain several alkaloids and essential oil (0.2%). The methiodide and methchloride derivatives of hayatine (alkaloid) were reported to be potent neuromuscular blocking agents and produces varying degrees of fall in blood pressure (Patnaik et al, Ind. J. Exp. Biol. 11, 1973, 89–94). The methiodide was found to be one-third as potent as tubocurarine chloride and 1.5 times as potent as gallamine. Hayatine methocholoride has a direct inotropic effect on the isolated cardiac muscle.    Pharmacology: The roots posses astringent, mild tonic, diuretic, stomachic, antilithic, analgesic, antipyretic and emmenagogue properties. They are frequently prescribed for cough, dyspepsia, dropsy, urino-genital troubles such as prolapsus uteri, cystitis, haemorrhage and menorrhagia, and calcular nephritis (Kirtikar and Basu, 1933, Vol. 3, 2146–2147). The juice is given to cattle also for curing diarrhoea. The root-paste is eruptions on the body of babies (Bhatnagar et al, Ind. J. Med. Res. 49, 1961, 799–807). Cissampareine, a bis-benzyl-isoquinoline alkaloid, showed a significant and reproducible inhibitory activity against human carcinoma cells of the naso-pharynx in cell culture. The roots show significant antibacterial activity against gram-positive organisms than against gram-negative strains (Adesina, Fitoterapia. 53, 1982, 147–162). An ethanolic extract (50%) of the stem and root shows CNS-depressant activity. The plant is also mentioned for the antidiarrhoeal properties ethnobotanically (Jain, 1991), but there was no scientific validation of the plant for this activity.MANGIFERA INDICA     Family: Anacardiaceae    Part used: Seed Kernels    Botanical description: A large number of mango types, estimated at over 1000 are grown in various parts of India, each having its own peculiar taste, flavour and consistency of pulp. The trees dies not bear abundant fruit in the humid zones of lower Bengal, Assam, Kerala, and south-east Madras, since there is no chilly winter in these regions. The mango cannot stand frost and therefore does not thrive in the hills of Punjab, Uttar Pradesh and the temperate regions of Himachal Pradesh and Kashmir above 900 m. In the frost-free plains and hills of Peninsular India, the mango grows from sea level up to 1,200 m., but is commercially unsuccessful at elevations above 900 m. The mango is the most popular and the choicest fruit of India and occupies a prominent place among the best fruits of the world. Few other tropical fruits have the historic reputation mango possesses and few others are so intimately connected with Indian folklore. Mangoes thrive in parts of North India where temperature is as high as 115–120° F. Prevail during the summer; however, high temperature accompanied by strong wind breaks, preferably shisham (Dalbergia sissoo) and other trees, are planted to the south-west of mango plantations to arrest the winds. Young and unripe fruits are usually acidic and used in pickles, chutney, amchur and culinary preparations. Ripe fruits are preserved by canning or used in the manufacture of juice and squash, jams and jellies, preserves (murraba) and am papar.    Medicinal use: The bark is used in diphtheria and rheumatism. It is believed to possess a tonic action on the mucus membrane. Dried flowers are astringent and are used for diarrhoea, chronic dysentery and bleeding disorders. The dried kernel is used as feed for cattle and poultry.    Phytochemistry: Analysis of the flesh of Indian mangoes gave the following average values: green mango—moisture, 90.0; protein, 0.7; fat, 0.1; carbohydrates, 8.8; mineral matter, 0.4; calcium, 0.01; and phoshorus, 0.02%; iron, 4.5 mg/100 g; carotene (as vitamin A), 150 i.u., riboflavin, 30 μg; and ascorbic acid, 3 mg/100 g; ripe mango—moisture, 86.1; protein, 0.6; fat, 0.1; carbohydrates, 11.8; fibre, 1.1; mineral matter, 0.3 mg/100 g; carotene (as vitamin A), 4.800 i.u.; nicotinic acid, 0.3 mg; riboflavin, 50 μg; and ascorbic acid 13 mg/100 g. The sugar and acid contents vary widely with variety and stage of maturity 9Table 4). Table 5 gives pH, sugar and β-carotene conents of pulps of some vrieties of ripe mango (Hlth Bull., No. 23, 1951, 46; Cheema et al., Indian J. Agric. Sci., 1950, 20, 259).
The green tender fruit is rich in starch during ripening, the starch is hydrolysed into reducing sugars and a part of the latter is synthesized into sucrose. Unripe, fully developed mangoes of pickling varieties contain citric, malic, oxalic, succinic and two unidentified acids (probably di- or tri-basic acids); citric acid is the dominant constituent. As the fruit ripens, the acidity gradually decreases with a steep fall at the ripe stage. The amnio acids present in the non-protein nitrogen fraction of the mango fruit are: aspartic acid, glutamic acid, alanine, glycine, methionine, leucines and possibly cystine and γ-amino-butryic acid (Govindarajan & Sreenivasaya, Curr. Sci., 1950, 19, 234). The concentration of carotenoid pigments increases during ripening: the rate of increase of β-carotene is greater than that of others and an average-sized mango may synthesize as much as 1,200 μg of β-carotene in a day. The fruit is a rich source of potassium. Analysis of pulp ash (ash content, 0.53%) gave the following values: potassium (K2O), 47.37; calcium (CaO), 6.38; magnesium (MgO), 1.62; Phosphorus (P2O5), 6.49; sulphur (SO3), 3.67; and chlorine, 3.88%, Copper (1.9 μg/g) and iodine (16 μg/kg) are present in the ripe fruit.    Pharmacology: The extracts of leaves, bark, stem and unripe fruit exhibits moderate antibacterial activity against Mcrocroccus pyogenes var. aureus. The occurrence of anti-fungal properties has been reported. The seed kernels have an astringent taste. They are used as human food of certain parts of India in times of scarcity. They are some times roasted or boiled for eating (Wealth of India, 1992).CINNAMOMUM Sps. (F. Hamilt.) Nees and Eberm.    Family: Lauraceae    Part used: Leaves and Barks    Botanical description: The species is the source of tejpat leaves used extensively in north India as a spice. The bark of the tree, known in trade as Indian cassia bark or Indian Cassia Lignea, is collected from trees growing at the foot of Sikkim and Himalayas. The plant is a medium sized tree, 7.5 m in height and 1.35 m in girth, distributed in tropical and subtropical Himalayas at an altitude of 1,000–1800 m, in Sikkim, Assam and Mizorum (Agarwal et al, Indian Perfumer. Vol. XXI, No. 1, 1977, 15–20). Leaves found cultivated in Tripura. Bark dark brown: leaves opposite or sometime alternate, elliptic to oblong-lanceolate, glabrous, 3-nerved at base, pink when young; flowers pale yellow, pubescent, in panicles; fruits black, ovoid, on the thickened peduncle and enlarge base of the perianth.    Medicinal use: The leaves are reported to be hypoglycemic, stimulant, carminative, antidote for scorpion sting and are used in colic, diarrhoea and rheumatism. They are considered hot and cardiac and are used with long pepper and honey in coughs and cold. Two teaspoonfuls of the powder given to diabetic patients four times a day for one month, accompanied by controlled diet, significantly reduces the blood sugar level and helps in release or manufacture of more insulin (Kirtikar & Basu, 2nd ed., 1987, Vol. 1, 499–505).
The dried leaves act as antioxidant to oils and fats. The inner bark of the shoots of the cinnamon tree is a powerful local stimulant, which acts to ease the stomach and relieve spasms; it is also a mild astringent. The leaves are bitter, sweet, aromatic, thermogenic, alexeteric, anthelmintic, diuretic, stimulant, carminative and tonic. They are used in cardiac disorders, inflammations, helminthiasis, dyspepsia, strangury, colic, hyperptyalism, ophthalmia, vitiated conditions of vata, diarrhoea, proctitis, proctalgia, hepatopathy and splenopathy (Anonymous, 1994). Essential oil of the leaves has been reported for the antifungal activity against Rhizocotnia bataticola, Fusarium moniliforme, Rhizoctonia solani, Pythium vexans and Alternaria helianthi (Girjune et al, Indian drugs. 16, 1978, 24–26). The plant was active against S. cerevesiae at higher doses while inactive against B. subtilis and E. coli (Minakshi et al, J. of Spices and Aromatic Crops. 8(2), 1999, 135–144). The plant leaves oil is reported to active against E. coli, P. aeruginosa, S. faecalis and S. pyogenes (Current Sci, 1978, 47(13), July 5, 454–455). The essential oils of the leaves were potentially active (at 1000 ppm) against the Trichophyton mentagrophytes and Microsporum audounil causing ringworm diseases in animals and human being (Yadav and Dubey, Ind. J. Pharm. Sci. 6, 1994, 227–230). It has also found active for the cure of dermatomycosis in the form of the herbal formulation as active against Trichophyton mentagrophytes and Microsporum audounil (Yadav et al, J. Med. Aromatic Plant Sci. 1999, 347–351).    Phytochemistry: The leaves yield an essential oil (0.3–0.6%). A sample of oil from Kumaun hills (UP) and Joginder Nagar shows the following physicochemical characteristics, respectively: sp gr30*, 0.9730–0.9876, 0.9349; ester val, 54.13, 45.49; ester val after acetylation, 149.82, 152.70; aldehyde content, 49.5, 38.4 and phenol content in trace, 4.7–5.2% (Sood et al, 1979). The nD28=1.4791, d28=0.9034 and [α] D28=+6 (Nath et al, 1994). The chemical composition of two oils was as follows, respectively; cinnamic aldehyde, 41.2, 12.8; linalool, 15.7, 50.3; eugenol, 13.3, 1.0; eugenol acetate, 12.5,-; β-caryophyllene, 4.0,-; benzaldehyde, 4.1, 1.1; camphor, 3.2,-; cadinene, 3.1, -: and α-terpineol, 1.8, 2.9% (Iijas, 1978). Among the various components identified in the essential oil of Cinnamomum sps., linalool was reported as the main constituent and constituted 60.73% of the oil (Nath et al, J. of Spices and Aromatic Crops. 3(1), 1994, 33–35). A sample of oil from Assam (yield, 2%) has, however, been found to contain as high as 80–85 percent eugenol. The oil from the bark contains cinnamaldehyde (70–85%) as a major constituent. The leaves also contain 3,4′,5,7-tetrahydroxy flavone, 3,3′,4′,5,7-pentahydroxy flavone, kaempferol-3-O-glucopyranoside, kaempferol-3-O-sophoroside, kaempferol-3,7-di-O-rhamnopyranoside and quercetin 3-O-rutinoside.    Pharmacology: Drug powder when administered with diabetes (insulin independent) has shown decrease in glucose level when kept on sugar and starch free regulated diet (1800 calories/day) for one month (Tripathi et al, J. Res. Indian. Med. Yoga H. 19, 1979, 159–160; Chandola et al, J. Res. Ayur. Siddha. 1, 1980, 275–281). The Cinnamomum sps. Blume (Chinese name: Rougui, English name: Chinese cinnamon) is recommended in stomach ache; Diarrhoea, shock; cold; clammy extremities; cough and wheezing; pain in the lower part of the body and knees; dysmenorrhoea, amenorrhoea, low blood pressure; frost-bite.    Buchanania lanzan linn    Family Anacardiaceae    Part used: Bark    Botanical Description: The genus includes 20 species of tree and shrubs, 6 of which occur in India. It is distributed in tropical Asia, Australia & the Pacific Islands. The tree is found in dry deciduous forest throughout India and Burma; in northwestern India from Sutluj to Nepal ascending to 3000′. The wood is light grey to greyish brown, some times with a light yellow cast, heartwood dark brown and rather lustrous while first exposed. The bark powder is buff to brown in color. It possesses slightly pungent odour and astringent taste.    Medicinal properties: The leaves are reported for their tonic and cardiotonic properties, their powder is common medicine for the wounds. The stem exudes a pale colour gum, which is used in intercostals pains. The gum dissolve in cow's milk is used internally in rheumatic pains.    Phytochemistry: Triglyceride composition of Buchanania lanzan seed oil were studied by Sengupta and Roychoudhury (J Sci Food Agric. 28(5), 2001, 463–468) and the flavonoids of the leaves were studied by Arya et al (J. Ind. Chem. Soc. 65, 1988, 882–883) while myricetin 3′-rhamnoside-3-galactoside was identified by Arya et al (Phytochemistry. 31 (7), 1992, 2569–2570). The presence of triterpenoids, saponins, reducing sugars and flavonoids is also reported. The bark contains 13.4% of tannins and 9.4% of non-tannins.    Pharmacology: A pellucid gum, resembling Bassora gum, exudes from wounds on stress. Effect of water extract of the bark of Buchanania lanzan linn. on behaviour and chromatophores of a fresh water fish, Labeo rohita was studied. (Chaudhary et al, J. Environ Biol. 22(3), 2001, 229–31). Products of plant given to mothers after childbirth or to invalids were studied for immunostimulant activity using the macrophage migration index (MMI) as a parameter of macrophage activation and cell-mediated immunity and haemagglutinating antibody (HA) titres and plaque-forming cell (PFC) counts as parameters of humoral immunity (Puri et al. J. Ethnopharmacol. 71(1–2), 2000, 89–92).
Hitherto, we present a novel synergistic herbal formulation, which contains plants, which have been used traditionally for the treatment of diarrhoea. Hence a study was undertaken to develop a synergistic combination of the traditionally used plants to develop a novel formulation effective in the treatment of diarrhoea.